Medical instrument handling device and surgical robot

Abstract

The application relates to a medical instrument operating device and a surgical robot, wherein the medical instrument operating device realizes swinging in each direction around an RCM point and linear motion of a medical instrument through swinging and rotating of first and second support arms and passive joints, meets the requirements of different visual fields and image zooming in or out during surgery, and facilitates linear extraction of an endoscope from a patient's body without additional linear motion mechanisms. Therefore, active joints and linear motion mechanisms are not needed between the passive joints and the medical instrument, so that the medical instrument does not have a tendency to move into the abdominal cavity. Even if the first to fourth active joints fail and lose support for the passive joints, the passive joints will be dragged to move away from the puncture device, so that the medical instrument has a tendency to exit the abdominal cavity, damage to intracavity tissues is avoided, and safety is improved.

Description

Technical Field

[0001] This application relates to the field of medical device technology, and in particular to a medical device manipulation device and a surgical robot. Background Technology

[0002] Minimally invasive techniques are designed to reduce the amount of tissue damaged during surgery, thereby reducing patient recovery time. These techniques can be performed through the patient's natural opening or through one or more surgical incisions.

[0003] Minimally invasive techniques utilize medical instruments (such as endoscopes, forceps, and other surgical instruments) and employ a multi-degree-of-freedom jointed robotic arm to manipulate these instruments, allowing them to pass through a trocar into the abdominal cavity. The robotic arm then moves the instrument around a remote center of motion (RCM) to achieve the desired posture and position. To minimize the impact of the moving medical instrument on the trocar, the robotic arm typically incorporates passive joints. These passive joints enable telecentric movement, adaptively positioning the trocar and preventing additional damage to surrounding tissues, thus ensuring a high level of safety.

[0004] In existing medical robotic arm solutions, an active deflection joint or linear motion mechanism is also set between the passive joint and the medical device. The active deflection joint's small-range rotation enables the medical device's posture adjustment, or the linear motion mechanism enables image magnification and reduction. However, under the influence of gravity, the endoscopic device always has a tendency to move into the abdominal cavity. If the active deflection joint or linear motion mechanism malfunctions and loses its restraint, the medical device can easily slide into the abdominal cavity, damaging intracavitary tissues and posing a significant safety hazard. Summary of the Invention

[0005] Therefore, it is necessary to provide a medical device manipulation device and surgical robot to address the problem that medical devices can easily slide into the abdominal cavity when the active deflection joint or linear motion mechanism fails and loses restraint, posing a significant safety hazard.

[0006] This application provides a medical device manipulation device configured to move a medical device around a remote center of motion, characterized in that it includes:

[0007] Base;

[0008] The first adapter bracket is rotatably connected to the base;

[0009] The first active joint is used to drive the first adapter bracket to rotate relative to the base;

[0010] The first support arm, the second support arm, and the instrument carrier arm extend sequentially from the first adapter bracket, and the medical device is mounted on the instrument carrier arm.

[0011] The second active joint is used to drive the first support arm to swing relative to the base;

[0012] The third active joint is used to drive the second support arm to swing relative to the first support arm;

[0013] The fourth active joint is used to drive the second support arm to rotate;

[0014] A passive joint is provided between the instrument support arm and the second support arm so that the instrument support arm swings in accordance with the position of the second support arm;

[0015] The fifth active joint is used to drive the rotation of the instrument support arm, and the rotation axis of the instrument support arm passes through a remote motion center.

[0016] The swing axis of the first support arm is perpendicular to the rotation axis of the first adapter bracket, and the swing axis of the second support arm is perpendicular to the swing axis of the first support arm.

[0017] The rotation axis of the second support arm and the rotation axis of the instrument support arm intersect at the swing axis of the instrument support arm.

[0018] This application also provides a surgical robot, comprising:

[0019] Medical device control device as described above;

[0020] The main control panel is used to control the medical device operating mechanism.

[0021] This application relates to a medical device manipulation device and a surgical robot. Through the swinging and rotation of the first and second support arms and passive joints, it achieves swinging in various directions around a remote motion center and linear movement of the medical device. This meets the needs of different fields of view and image magnification / reduction during surgery, and facilitates the linear withdrawal of the endoscope from the patient's body without the need for additional linear motion mechanisms. Therefore, no additional active joints or linear motion mechanisms are required between the passive joints and the medical device, preventing the medical device from moving into the abdominal cavity. Even if the first to fourth active joints malfunction and lose support for the passive joints, the passive joints will be dragged away from the trocar, causing the medical device to tend to exit the abdominal cavity, avoiding damage to intra-abdominal tissue and improving safety. Attached Figure Description

[0022] The accompanying drawings, which form part of this application, are used to provide a further understanding of the application and to make other features, objects, and advantages of the application more apparent. The illustrative embodiments and descriptions of this application are used to explain the application and do not constitute an undue limitation of the application.

[0023] Figure 1 This is a perspective view of the arm-shaped structure in a medical device control device provided in an embodiment of this application.

[0024] Figure 2 This is a schematic diagram of the overall structure of a medical device control device provided in an embodiment of this application.

[0025] Figure 3 A perspective view of another state of the arm-shaped structure in a medical device manipulation device provided in an embodiment of this application.

[0026] Figure 4 An exploded view of the passive joint and the fifth active joint in a medical device manipulation device provided in an embodiment of this application.

[0027] Figure 5 A perspective view of the clamping device in a medical device manipulation device provided in an embodiment of this application.

[0028] Figure 6 A perspective view of the lifting device and handle in a medical device operating device provided in an embodiment of this application.

[0029] Figure label:

[0030] 100 - Medical device control device; 111 - Base; 112 - First adapter bracket;

[0031] 120 - First active joint; 121 - First actuator; 113 - First support arm;

[0032] 114 - Second support arm; 115 - Instrument support arm; 116 - Second adapter bracket;

[0033] 130 - Second active joint; 131 - Second actuator; 140 - Third active joint;

[0034] 141 - Third actuator; 150 - Fourth active joint; 151 - Fourth actuator;

[0035] 160 - Passive joint; 161 - Rotating shaft; 162 - Additional encoder; 170 - Fifth active joint;

[0036] 171-Swing block; 172-Cover; 173-Fifth actuator; 200-Clamping device;

[0037] 210 - Base; 211 - Slide groove; 220 - First clamping component; 221 - First V-groove;

[0038] 230 - Second clamping component; 231 - Second V-groove; 240 - Adjusting screw; 241 - Forward action part;

[0039] 242 - Reverse action part; 243 - Operating part; 250 - First nut; 260 - Second nut;

[0040] 310 - Cart; 311 - Casters; 320 - Lifting device; 321 - Screw drive mechanism;

[0041] 322-Lifting motor; 323-Mountain frame; 324-Support column; 325-Linear guide rail; 326-Frame;

[0042] 330 - Handle; 400 - Medical device. Detailed Implementation

[0043] To make the objectives, technical solutions, and advantages of this application clearer, the following detailed description is provided in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative and not intended to limit the scope of this application.

[0044] This application provides a medical device manipulation device 100. It should be noted that the medical device manipulation device 100 provided in this application can be applied to any type of medical device 400, such as surgical instruments like manipulators and dissecting forceps, and endoscopes.

[0045] like Figure 1 As shown, in one embodiment of this application, the medical device manipulation device 100100 is configured to move the medical device 400 around a remote center of motion (i.e., RCM point). The medical device manipulation device 100 includes: a base 111, a first adapter bracket 112, a first active joint 120, a first support arm 113, a second support arm 114, a device carrying arm 115, a second active joint 130, a third active joint 140, a fourth active joint 150, a passive joint 160, and a fifth active joint 170.

[0046] Specifically, the first adapter bracket 112 is rotatably connected to the base 111. A first support arm 113, a second support arm 114, and an instrument support arm 115 extend sequentially from the first adapter bracket 112 to form an arm-shaped structure. The first support arm 113 is rotatably connected to the first adapter bracket 112, and the medical device 400 is disposed on the instrument support arm 115.

[0047] A first active joint 120 drives the first adapter bracket 112 to rotate relative to the base 111. A second active joint 130 drives the first support arm 113 to swing relative to the base 111. A third active joint 140 drives the second support arm 114 to swing relative to the first support arm 113. A fourth active joint 150 drives the second support arm 114 to rotate. A passive joint 160 is disposed between the instrument support arm 115 and the second support arm 114, so that the instrument support arm 115 swings following the position of the second support arm 114. A fifth active joint 170 drives the instrument support arm 115 to rotate, and the rotation axis 161 of the instrument support arm 115 passes through a remote center of motion (RCM point).

[0048] It should be noted that an active joint indicates rotation driven by an actuator, while a passive joint 160 indicates rotation without an actuator.

[0049] The swing axis of the first support arm 113 is perpendicular to the rotation axis of the first adapter bracket 112. The swing axis of the second support arm 114 is perpendicular to the swing axis of the first support arm 113, such that the first support arm 113 and the second support arm 114 swing in two perpendicular planes. The rotation axis 161 of the second support arm 114 and the rotation axis 161 of the instrument support arm 115 intersect at the swing axis of the instrument support arm 115, and both the rotation axis 161 of the second support arm 114 and the rotation axis 161 of the instrument support arm 115 are perpendicular to the swing axis of the instrument support arm 115.

[0050] In this embodiment, the swinging and rotation of the first support arm 113 and the second support arm 114, along with the passive joint 160, enable the swinging in various directions around the remote motion center and the linear motion of the medical device 400. The swinging angle ranges from 0 to 90°, and the linear motion distance ranges from 0 mm to 240 mm. This meets the needs of different fields of view and image magnification / reduction during surgery, and facilitates the linear withdrawal of the endoscope from the patient's body without the need for an additional linear motion mechanism. Therefore, no additional active joint or linear motion mechanism is required between the passive joint 160 and the medical device 400, preventing the medical device 400 from moving into the abdominal cavity. Even if the first active joint 120 to the fourth active joint 150 malfunction and loses support for the passive joint 160, the passive joint 160 will be dragged away from the trocar, causing the medical device 400 to tend to exit the abdominal cavity, thus avoiding damage to intra-abdominal tissues and improving safety.

[0051] Furthermore, since no additional linear motion mechanism is required, the end space size of the medical device manipulator 100 is reduced, and the end weight is also reduced.

[0052] Since the endoscope port and two instrument ports are generally arranged in an inverted triangle in clinical practice, the endoscope device must be positioned forward of the surgeon's armpit. In this application, the swing axis of the second support arm 114 is perpendicular to the swing axis of the first support arm 113. When the medical device manipulation device 100 supports the endoscope, the arm formed by the first support arm 113 and the second support arm 114 can horizontally pass from behind the operator, bypassing the operator's armpit, to a forward position, avoiding interference with the operator's position. This arrangement is completely consistent with the clinical standing position for holding an endoscope during surgery, thus not changing the surgical standing position or other facilities required for clinical surgery.

[0053] Furthermore, this application combines the mutual rotational relationship between the active and passive joints 160, and uses image recognition algorithms to control the movement of each joint, that is, to adaptively locate the lesion position by tracking the surgical instrument image recognition. Of course, the operator can also actively control the movement of the medical device manipulation device 100.

[0054] like Figure 1 As shown, in one embodiment of this application, the rotation axis of the second support arm 114 is perpendicular to the swing axis of the second support arm 114.

[0055] In this embodiment, since the second support arm 114 is directly connected to the passive joint 160, and by designing the second support arm 114 to have both rotational and swing degrees of freedom, the second support arm 114 can directly adjust the position and angle of the passive joint 160. Thus, a small range of adjustment of the second support arm 114 can enable the instrument support arm 115 to obtain a large positional change, avoiding the large swing of the second support arm 114 from affecting the operator's operation, and enabling a larger surgical operation range.

[0056] like Figure 3 As shown, in one embodiment of this application, the first active joint 120 includes a first actuator 121, which is fixed to the base 111, and the output shaft of the first actuator 121 is connected to the first adapter bracket 112. The first actuator 121 drives the first adapter bracket 112 to rotate, with the rotation angle ranging from -180° to +180°.

[0057] like Figure 3 As shown in one embodiment of this application, the second active joint 130 includes a second actuator 131, which is fixed to the first adapter bracket 112, and the output shaft of the second actuator 131 is connected to the first support arm 113. The second actuator 131 drives the first support arm 113 to swing relative to the first adapter bracket 112, with the swing angle ranging from -110° to +110°.

[0058] like Figure 3As shown, in one embodiment of this application, the medical device manipulation device 100 further includes a second adapter bracket 116, one end of which is rotatably connected to the first support arm 113, and the second support arm 114 is rotatably connected to the other end of the second adapter bracket 116.

[0059] The third active joint 140 includes a third actuator 141, which is fixed to the end of the first support arm 113 away from the second active joint 130. The output shaft of the third actuator 141 is connected to the second adapter bracket 116, so that the third actuator 141 drives the second adapter bracket 116 to swing relative to the first support arm 113, and then the second adapter bracket 116 drives the second support arm 114 to swing synchronously, with the swing angle ranging from -70° to 170°.

[0060] The fourth active joint 150 includes a fourth actuator 151, fixed to the second adapter bracket 116, and the output shaft of the fourth actuator 151 is connected to one end of the second support arm 114. A third actuator 141 drives the second support arm 114 to rotate relative to the second adapter bracket 116, with the rotation angle ranging from -180° to +180°.

[0061] like Figure 3 and Figure 4 As shown, in one embodiment of this application, the passive joint 160 is located at the end of the second support arm 114 away from the fourth joint. The passive joint 160 includes a rotating shaft 161 and an additional encoder 162.

[0062] The rotating shaft 161 is rotatably connected to the end of the second support arm 114, and the instrument support arm 115 is directly or indirectly anti-rotated connected to the rotating shaft 161. The instrument support arm 115 rotates and moves in relation to the RCM point support through the first active joint 120, the second active joint 130, the third active joint 140 and the fourth active joint 150, so that the instrument support arm 115 passively swings about the center line of the rotating shaft 161 as the axis, with the swing angle range of ±115°.

[0063] An additional encoder 162 is fixed to the second support arm 114, and its input shaft coincides with the axis of the rotating shaft 161. The input shaft of the additional encoder 162 is connected to the rotating shaft 161 to prevent rotation, and is used to detect the rotation direction and rotation angle of the rotating shaft 161.

[0064] like Figure 3 and Figure 4As shown, in one embodiment of this application, the fifth active joint 170 includes: a swing block 171, a housing 172, and a fifth actuator 173. The swing block 171 is fixedly fitted onto the rotating shaft 161, and the two can be fixed together by a pin or a spline connection. The housing 172 is fixedly connected to the swing block 171, and the instrument support arm 115 is rotatably connected to the housing 172. The fifth actuator 173 is fixedly disposed inside the housing 172, and its output shaft is connected to the instrument support arm 115 for driving the instrument support arm 115 to rotate relative to the housing 172, with a rotation angle range of -180° to +180°.

[0065] In this embodiment, the rotation of the medical device 400, such as an endoscope, is controlled by the instrument support arm 115, which can expand the surgical field of view.

[0066] It should be noted that the reference 0 position for the above rotation angle and swing angle is based on the fact that the center lines of all arms are in a straight line.

[0067] The actuator in this application includes a motor, a motor driver, and an encoder. The motor is a device that generates rotational driving force. The motor driver controls the rotational speed of the motor by adjusting the amount of current supplied to the motor. Under the control of the motor driver, the motor is driven to generate torque corresponding to the torque command value from the control unit. The encoder is used at least to detect the rotation angle of the motor's rotating shaft 161.

[0068] Optionally, the actuator may also include a reducer connected to the rotating shaft 161 of the motor, which reduces the rotational speed of the rotating shaft 161 of the motor by a predetermined reduction ratio and transmits the result to the output shaft, which drives the subsequent components.

[0069] Of course, the actuator in this application may also be a hydraulic motor or a pneumatic motor.

[0070] In one embodiment of this application, the medical device manipulation device 100 further includes: an additional active joint.

[0071] An additional active joint is disposed between the second active joint 130 and the third active joint 140, for driving the first support arm 113 to rotate relative to the first adapter bracket 112, so that the rotation axis of the first support arm 113 is perpendicular to the swing axis of the first support arm 113.

[0072] The arrangement of the additional active joint and the second active joint 130 is similar to the structural form of the third active joint 140, the second adapter bracket 116 and the fourth active joint 150, and will not be described in detail in the accompanying drawings.

[0073] In this embodiment, by increasing the rotational freedom of the first support arm 113, a small adjustment of the first support arm 113 can enable the second support arm 114 and the instrument support arm 115 to achieve a large change in position and posture, thus avoiding the large swing of the first support arm 113 from affecting the operator's operation, and allowing for a larger surgical operation range.

[0074] like Figure 3 and Figure 5 As shown, in one embodiment of this application, the medical device manipulation device 100 further includes a clamping device 200 for fixing the medical device 400 to the device support arm 115.

[0075] The clamping device 200 includes: a base 210, a first clamping member 220, and a second clamping member 230.

[0076] The base 210 is fixedly connected to the instrument support arm 115. The first clamping member 220 is slidably connected to the base 210 and is provided with a first V-groove 221. The second clamping member 230 is slidably connected to the base 210 and is provided with a second V-groove 231 corresponding to the first V-groove 221.

[0077] When the two clamping components approach each other, the first V-groove 221 and the second V-groove 231 cooperate to position the center line of the medical device 400 to be coaxial with the rotation direction of the device support arm 115.

[0078] Specifically, the included angle of the first V-groove 221 ranges from 115° to 145°, with a preferred value of 130°. The included angle of the second V-groove 231 ranges from 115° to 145°, with a preferred value of 130°.

[0079] In this embodiment, a V-groove positioning method is adopted, which enables the clamping device 200 of this application to clamp medical devices 400 with different diameters of Φ2-Φ10mm, which has good versatility and reduces surgical preparation work.

[0080] like Figure 5 As shown, in one embodiment of this application, the clamping device 200 further includes an adjusting screw 240, a first nut 250, and a second nut 260.

[0081] The adjusting screw 240 is rotatably connected to the base 210, and the adjusting screw 240 is configured with a forward-acting part 241 having forward threads, a reverse-acting part 242 having reverse threads, and an operating part 243. The operating part 243 is located outside the base 210. The base 210 is provided with a sliding groove 211, and the forward-acting part 241 and the reverse-acting part 242 are respectively located in the sliding groove 211.

[0082] The first nut 250 is fixedly connected to the first clamping member 220, and the first nut 250 is screwed into the forward-acting part 241. The second nut 260 is fixedly connected to the second clamping member 230, and the first nut 250 is screwed into the reverse-acting part 242. The first nut 250 and the second nut 260 are respectively embedded in the sliding groove 211.

[0083] In this embodiment, by rotating the operating part 243, the forward-acting part 241 and the reverse-acting part 242 are driven to rotate synchronously, so that the clamping parts approach each other at the same speed to clamp the medical device 400. Since the adjusting screw 240 has a self-locking function, it will not loosen after clamping, and the operation is convenient.

[0084] like Figure 2 and Figure 6 As shown in one embodiment of this application, the medical device operating device 100 further includes a trolley 310 and a lifting device 320.

[0085] The trolley 310 is configured to have multiple casters 311. A lifting device 320 is fixed to the trolley 310 and is used to drive the base 111 to lift.

[0086] Specifically, the lifting device 320 includes a frame 326, a lead screw transmission mechanism 321, a lifting motor 322, a movable frame 323, and a linear guide rail 325.

[0087] Frame 326 is fixedly connected to trolley 310 to provide support for screw drive mechanism 321. Screw drive mechanism 321 is fixedly mounted on frame 326, and base 111 is fixed to movable frame 323 by multiple supports 324. Lifting motor 322 drives screw drive mechanism 321 to push movable frame 323 up and down, thereby realizing the overall lifting of arm-like structure to meet the height requirements of different surgical scenarios. Linear guide rail 325 is arranged vertically to guide movable frame 323 during lifting to maintain the stability of movable frame 323.

[0088] The medical device control device 100 also includes a handle 330. The handle 330 is fixedly connected to the trolley 310 or the lifting device 320. By pushing or pulling the handle 330, the casters 311 of the trolley 310 can be rolled, thereby realizing the overall displacement of the medical device control device 100.

[0089] This application also provides a surgical robot.

[0090] In one embodiment of this application, the surgical robot includes a medical device manipulation device 100 as described above and a main control panel, the main control panel being used to control the medical device manipulation device 100.

[0091] The technical features of the above embodiments can be combined arbitrarily, and the execution order of the method steps is not restricted. For the sake of brevity, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

[0092] The embodiments described above are merely illustrative of several implementation methods of this application, and while the descriptions are specific and detailed, they should not be construed as limiting the scope of this patent application. It should be noted that those skilled in the art can make various modifications and improvements without departing from the concept of this application, and these all fall within the protection scope of this application. Therefore, the protection scope of this application should be determined by the appended claims.

Claims

1. A medical device control device configured to move a medical device around a remote center of motion, characterized in that, include: Base; The first adapter bracket is rotatably connected to the base; The first active joint is used to drive the first adapter bracket to rotate relative to the base; The first support arm, the second support arm, and the instrument carrier arm extend sequentially from the first adapter bracket, and the medical device is mounted on the instrument carrier arm. The second active joint is used to drive the first support arm to swing relative to the base; The third active joint is used to drive the second support arm to swing relative to the first support arm; The fourth active joint is used to drive the second support arm to rotate; A passive joint is provided between the instrument support arm and the second support arm so that the instrument support arm swings in accordance with the position of the second support arm; The fifth active joint is used to drive the rotation of the instrument support arm, and the rotation axis of the instrument support arm passes through a remote motion center. The swing axis of the first support arm is perpendicular to the rotation axis of the first adapter bracket, and the swing axis of the second support arm is perpendicular to the swing axis of the first support arm. The rotation axis of the second support arm and the rotation axis of the instrument support arm intersect at the swing axis of the instrument support arm, and the rotation axis of the second support arm and the rotation axis of the instrument support arm are respectively perpendicular to the swing axis of the instrument support arm. The rotation axis of the second support arm is perpendicular to the swing axis of the second support arm; The medical device control device also includes: The second adapter bracket has one end rotatably connected to the first support arm, and the second support arm rotatably connected to the other end of the second adapter bracket; The third active joint includes: A third actuator is fixed to the first support arm, and the output shaft of the third actuator is connected to the second adapter bracket; The fourth active joint includes: A fourth actuator is fixed to the second adapter bracket, and the output shaft of the fourth actuator is connected to the second support arm; The passive joint includes: A rotating shaft is rotatably connected to the end of the second support arm, and the instrument support arm is directly or indirectly anti-rotated connected to the rotating shaft; An encoder, wherein the input shaft coincides with the axis of the rotating shaft, and the input shaft is connected to the rotating shaft in a non-rotating manner; The fifth active joint includes: The swing block is fixedly fitted onto the rotating shaft; The cover is fixedly connected to the swing block, and the instrument support arm is rotatably connected to the cover; The fifth actuator, located inside the housing, is used to drive the instrument support arm to rotate relative to the housing.

2. The medical device control device according to claim 1, characterized in that, The medical device control device also includes: An additional active joint is disposed between the second and third active joints to drive the first support arm to rotate relative to the first adapter bracket, so that the rotation axis of the first support arm is perpendicular to the swing axis of the first support arm.

3. The medical device control device according to claim 1, characterized in that, The medical device control device also includes: A clamping device is used to fix the medical device relatively to the device support arm; The clamping device includes: The base is fixed to the support arm of the instrument; The first clamping component is slidably connected to the base and is provided with a first V-shaped groove; The second clamping component is slidably connected to the base and is provided with a second V-shaped groove corresponding to the first V-shaped groove. When the two clamping components approach each other, the first V-groove and the second V-groove cooperate to position the centerline of the medical device coaxial with the rotation direction of the device support arm.

4. The medical device control device according to claim 3, characterized in that, The clamping device further includes: An adjusting screw is rotatably connected to the base, and the adjusting screw is configured as a positive action part with positive threads, a negative action part with negative threads, and an operating part; The first nut is fixedly connected to the first clamping member, and the first nut is screwed into the positive action part; The second nut is fixedly connected to the second clamping member, and the first nut is screwed to the reverse action part; The operating part is located outside the base, and the base is provided with a sliding groove. The forward-acting part and the reverse-acting part are respectively located in the sliding groove; the first nut and the second nut are respectively embedded in the sliding groove.

5. The medical device control device according to claim 1, characterized in that, The medical device control device also includes: The trolley is configured to have multiple casters; A lifting device, fixed to the trolley, is used to drive the base to lift.

6. A surgical robot, characterized in that, include: The medical device control device as described in any one of claims 1 to 5; The main control panel is used to control the medical device operating mechanism.

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